PCOS 101

Illustration by Xiao Mei

by Jo Murphy

How PCOS Affects Your Sex Drive

If you have Polycystic Ovary Syndrome, you have low libido, right? Well, truth be told, it’s not that simple. Commonly known as PCOS, it encompasses a whole spectrum of ovarian disorders and some of those can make you horny as hell. It gets even more complicated when you learn that PCOS shows up as a variety of symptoms easily confused with other hormonal irregularities. So, how the heck do you know if PCOS is affecting your sex drive?  

What Is Polycystic Ovary Syndrome?

Let’s first get a handle on what PCOS really means. Polycystic ovary syndrome is technically an umbrella term rather than a syndrome, as it refers to the different ovarian or follicular disturbances that can take place in the female body.

There really is no one-size-fits-all approach to diagnosis or cure says Keris Marsden, a Naturopathic Nutritional Therapist and co-founder of Fitter Food. “We have to be careful when talking about this because it could be PCO rather than PCOS (or neither).” Which means the way this affect your libido and sex drive differs too.

Does PCOS Affect Sex Drive or Libido?

Here’s another crucial piece of information: your sex drive and libido are not one and the same—but they can both provide essential feedback when it comes to understanding what’s going on with your body. Your sex drive is your mental and emotional desire for action while your libido is your body’s ability to become aroused in response.

You may therefore want sex but are unable get wet, or you could be well lubricated but not in the mood. In either scenario, it’s likely a surplus or shortage of hormones that has slammed on the sex brakes.

Do You Have PCOS or PCO?

“It’s not abnormal to have what look like cysts on your ovaries that are actually multiple maturing follicles (rather than cysts),” says Keris, “and one in four women is estimated to have these.” If, however, you have actual cysts on your ovaries but none of the clinical symptoms associated with PCOS, you may be diagnosed with polycystic ovaries or PCO instead. This could still disrupt your menstrual cycle as well as the balance of sex hormones. Confused yet? Wait until you hear about the androgens…

What Do Male Hormones Have to Do With It?

Androgens is the official name for ‘male’ hormones; we all have androgens, regardless of gender . You’ll have heard of testosterone, the key sex hormone needed for arousal, but you may not have heard that testosterone is produced in the ovaries and is necessary for estrogen synthesis. If you therefore produce too much or not enough androgens, the chances are your whole sex hormone symphony will be out of tune—along with your libido and/or your sex drive.   

High Libido, Low Sex Drive

High androgen (or testosterone) levels are associated with high libido, yet sex might not be on your mind since excess male hormones can cause the kind of symptoms that leave you feeling a little less than sexy. These include weight gain, excess hair growth in places you can’t hide, like the chin or upper lip, and even some hair loss akin to male pattern balding. While these traits aren’t inherently unsexy, you may not like them on you.

Not all women with high androgens will have PCOS, but if you do, you’ll experience any of the above symptoms in tandem with irregular or absent periods. If you’re struggling to keep the weight off, you may also be suffering with insulin resistance—which basically means your body isn’t responding so well to insulin.    

Low Libido, Low Sex Drive

Low androgens can lead to low everything—energy, estrogen, libido and sex drive. “This generally happens in women who are underweight and under a lot of stress,” says Keris. “You might be working or exercising too much or not eating enough, all of which can disrupt the link between the brain and the ovaries, causing the menstrual cycle to cease for months at a time.” Any disruption to follicle maturation and ovulation can lead to low levels of estrogen and progesterone, which can cause vaginal dryness – another sex brake.  

It’s also worth noting that if you’re not eating enough, you may not be getting enough cholesterol, which isn’t the nutritional baddie you think it is. “The ovarian follicles take in cholesterol and turn it into the testosterone needed to produce estrogen,” Keris explains. “It therefore provides the building blocks of your reproductive hormones. What’s more, this process is enabled by enzymes, and enzymes can’t operate without vitamins or minerals.”

Your Body Knows, So Know Your Body

If you suspect something’s amiss with your hormones, get a blood test. “Doctors will often look at both pituitary and ovarian hormones to find the root cause,” says Keris, but also bear in mind that if you’ve just come off the contraceptive pill (or any other hormonal contraception), your body will need time to find its natural rhythm.

“Some women’s bodies favor the production of more potent forms of testosterone, which are associated with the symptoms of PCOS, while others don’t,” Keris adds. “So, it really comes down to your genetic makeup as well as your lifestyle. It’s never just one thing.”

A blood test may therefore not be sufficient to explain your symptoms, as your hormones could be red flagging other areas of your life that need some TLC. “I recommend looking at the four pillars: nutrition, sleep, movement and mindset. They all affect different hormones and if just one is off kilter, they’re all impacted.”

Libido As Lifestyle Feedback

Your hormones are responsible for many daily changes that take place within the body from regulating sleep to regulating appetite and libido. Quick wins come with regular sleep and a diet that covers your nutritional needs.

Fiber, such as chia seeds, flaxseeds and whole grains, will help to excrete excess hormones. Whereas zinc-rich foods, like seafood and red meat, can boost testosterone production. As for cholesterol, make sure you’re getting the good kind from fatty fish, olive oil and nuts.

When it comes to working out, be mindful that too much high intensity training can also interfere with the signals that travel between the brain and the ovaries, so this will impact your menstrual cycle. That said, strength training can also boost testosterone, so find a balance by not going all-out every day.

“Look at your relationships and environment too,” Keris advises. “If anything, these need to be addressed first. If your partner doesn’t support your lifestyle changes, then this is a barrier. The same goes for your job, so be careful about linking one aspect of your health with one outcome. PCOS is just one piece of information and the state of your libido, or sex drive, is a reflection of how your overall lifestyle is impacting your wellbeing.”